Melissa L. Martinson

The influence of stress and social support on depressive symptoms in mothers with young children

Limited research has examined the associations of stress, social support, and depression among mothers with young children over time. Longitudinal studies are needed to identify risk and protective factors for maternal depression given that depression can be cyclical and may affect women through the early years of their childrens development. This study examined the relationships among stress, social support, and depressive symptoms in a national sample of low-income urban American women with young children. A secondary data analysis of the Fragile Families and Child Wellbeing Study, a national longitudinal panel study of nearly 5000 births across 20 cities with populations of 200,000 or more in the United States, was conducted. The analytic sample included all mothers (N = 3675) who completed assessments at baseline through year 5 of the study between 1998 and 2005. Multivariate models using generalized estimating equations were used to estimate the probability of being depressed as a function of stress-related risk factors, social support factors, and sociodemographic variables. The rate of depression each year ranged from 15% to 21%. The results suggest that stress related to economic hardship, parenting, and poor physical health increases the risk of depression among low-income urban mothers with young children. Instrumental and partner support were found to be potential protective factors in reducing the negative effects of stress, but only to a certain degree. Future efforts are needed to strengthen social support and mitigate chronic stressors that contribute to mental health problems in low-income communities.

Health Across the Life Span in the United States and England

This study systematically compared health indicators in the United States and England from childhood through old age (ages 0-80 years). Data were from the 1999-2006 National Health and Nutrition Examination Survey for the United States (n = 39,849) and the 2003-2006 Health Survey for England (n = 69,084). Individuals in the United States have higher rates of most chronic diseases and markers of disease than their same-age counterparts in England. Differences at young ages are as large as those at older ages for most conditions, including obesity, low high-density lipoprotein cholesterol, high cholesterol ratio, high C-reactive protein, hypertension (for females), diabetes, asthma, heart attack or angina (for females), and stroke (for females). For males, heart attack or angina is higher in the United States only at younger ages, and hypertension is higher in England than in the United States at young ages. The patterns were similar when the sample was restricted to whites, the insured, nonobese, nonsmoking nondrinkers, and specific income categories and when stratified by normal weight, overweight, and obese weight categories. The findings from this study indicate that US health disadvantages compared with England arise at early ages and that differences in the body weight distributions of the 2 countries do not play a clear role.

A Cross-National Comparison of Racial and Ethnic Disparities in Low Birth Weight in the United States and England

OBJECTIVE. We used 2 new nationally representative surveys to compare racial and ethnic differences in low birth weight in the United States and England. METHODS. Risk factors and rates of low birth weight were compared across groups for singleton births within each country (white, black, Hispanic, Asian, and American Indian mothers in the United States; white, black, and Asian mothers in England). Crude rates and rates adjusted for socioeconomic status and behaviors were compared. Additional comparisons were limited to native-born mothers. RESULTS. Racial and ethnic disparities in low birth weight are as large in England as in the United States. Socioeconomic status and behaviors explain little of the variation across racial and ethnic groups in either country. CONCLUSIONS. Health disadvantages associated with being a minority do not seem to be a uniquely American phenomenon. Universal health care, as provided in the United Kingdom, alone may be insufficient to reduce racial and ethnic disparities in low birth weight.

Race/Ethnic and Nativity Disparities in Child Overweight in the United States and England:

Child overweight is a growing problem in wealthy countries. There is also evidence that child overweight varies by race/ethnicity and socioeconomic status. In this article, the authors use data from two recent birth cohort studies in the United States and England to address four questions: (1) Are race/ethnic and immigrant status associated with child overweight? (2) Is the association between socioeconomic status and child overweight similar across race/ethnic and nativity subgroups? (3) Does the age of immigrant mothers at migration moderate the association between immigrant status and child overweight? and (4) Does maternal obesity mediate the association between race/ethnicity and nativity and child overweight? Findings indicate that (1) race/ethnicity and immigrant status are risk factors for child overweight in both countries, (2) the influence of socioeconomic status differs by subgroup, (3) mother’s age at migration does not moderate the association, and (4) mother’s obesity mediates some of the race/ethnic disparities in child overweight.

Does Life in the United States Take a Toll on Health? Duration of Residence and Birthweight among Six Decades of Immigrants

We used data from the 1998–2009 waves of the National Health Interview Survey to investigate cohort differences in low birthweight among US-born children of mothers arriving in the United States between 1955 and 2009, cohort-adjusted patterns in low birthweight by maternal duration of residence in the United States, and cohort-adjusted patterns in low birthweight by maternal duration of US residence stratified by age at arrival and region of origin. We found a consistent deterioration in infant health with successive immigrant cohorts and heterogeneous effects of cohort-adjusted duration in the United States by age at arrival and region. Most notably, we found evidence that maternal health (as proxied by low birthweight) deteriorates with duration in the United States only for immigrant mothers who came to the United States as children. For mothers who arrived as adults, we found no evidence of deterioration. The findings underscore the importance of considering age at arrival and place of origin when studying post-migration health trajectories and provide indirect evidence that early life exposures are a key to understanding why the United States lags other developed nations in health.

Socioeconomic Inequalities in Low Birth Weight in the United States, the United Kingdom, Canada, and Australia.

OBJECTIVES To compare associations between socioeconomic status and low birth weight across the United States, the United Kingdom, Canada, and Australia, countries that share cultural features but differ in terms of public support and health care systems. METHODS Using nationally representative data from the United States (n = 8400), the United Kingdom (n = 12 018), Canada (n = 5350), and Australia (n = 3452) from the early 2000s, we calculated weighted prevalence rates and adjusted odds of low birth weight by income quintile and maternal education. RESULTS Socioeconomic gradients in low birth weight were apparent in all 4 countries, but the magnitudes and patterns differed across countries. A clear graded association between income quintile and low birth weight was apparent in the United States. The relevant distinction in the United Kingdom appeared to be between low, middle, and high incomes, and the distinction in Canada and Australia appeared to be between mothers in the lowest income quintile and higher-income mothers. CONCLUSIONS Socioeconomic inequalities in low birth weight were larger in the United States than the other countries, suggesting that the more generous social safety nets and health care systems in the United Kingdom, Canada, and Australia played buffering roles.

WEIGHT STATUS IN ADOLESCENCE IS ASSOCIATED WITH LATER LIFE FUNCTIONAL LIMITATIONS

Objectives: This study examines the relationship between weight status in adolescence and later life functional limitations. Method: We use the Wisconsin Longitudinal Study to characterize the relationship between standardized relative body mass ascertained from high school photograph portraits in 1957 and self-reported functional imitations in 2004. Results: Compared to individuals with normal body mass, those who were overweight in high school had poorer later life physical function, with observed gender differences. Women who were underweight in adolescence had better functioning in older adulthood than their normal weight counterparts. This relationship, however, was not found among men. Conclusions: These findings underscore the long-term consequences of being overweight in adolescence on the functional disadvantages conferred in late life.

Transdisciplinarity in Research: Perspectives of Early Career Faculty

Background: Early career faculty experiences and perspectives on transdisciplinary research are important yet understudied. Methods: Assistant professors at 50 top-ranked social work programs completed an online survey assessing perspectives on the salience of transdisciplinary training in their field, obstacles to or negative impacts of transdisciplinary training, and current environments. Content analysis and descriptive statistics were used. Results: A large majority of all participants (N = 118) believed that transdisciplinary research is important, that greater training is needed, and that they are relatively well prepared in related skill sets. They are expected to build cross-disciplinary collaborations, yet only a small minority believed that social work researchers are nationally recognized as important collaborators, or that they are prepared to navigate tensions on research teams. Conclusions: We offer a multilevel framework of structural and training supports needed to realize transdisciplinary research in social work with relevance to other disciplines.

Income disparities in cardiovascular health across the lifespan

Using data from the 1999–2014 National Health and Nutrition Examination Survey (n ~ 46,000), this study documents income disparities in the age patterning of cardiovascular conditions across the lifespan in the U.S. The conditions were assessed from laboratory test results, self-reports of medications used to treat specific conditions, and anthropometric measurements, allowing us to capture whether individuals at given ages had developed the various conditions, regardless of previous diagnosis and treatment. We found evidence of large income disparities in the presence of cardiovascular conditions and risk factors for females, smaller disparities in the same conditions for males, and few disparities that increased with age for either gender. Results were very similar when considering disparities by education instead of income. The findings suggest that the widening socioeconomic gradients in health over the lifespan found in many previous studies—which have generally focused on self-rated health, activity limitations, or diagnosed conditions—reflect, at least to some extent, differences in diagnosis, treatment, and management of health conditions rather than age-related differences in developing them. The findings also suggest that preventive healthcare is not an important source of socioeconomic disparities in cardiovascular health in the U.S., at least for men. The observed patterns of income disparities in cardiovascular conditions over the lifespan are more consistent with theories of early life conditions and the imprinting of health endowments and susceptibilities early in life than with cumulative life exposure or stress hypotheses.

The long-arm of adolescent weight status on later life depressive symptoms

BACKGROUND given the increase in worldwide obesity among children and adolescents, the long-term consequences of childhood obesity on the risk of adverse health outcomes in later life has garnered increased attention. Much of the work on earlier life weight status and later life health has focused on cardiovascular-related outcomes in mid- to late-adulthood; however, little is known about the later life mental health consequences of adolescent body weight. METHODS data came from the Wisconsin Longitudinal Study. We estimated gender-stratified logistic regression models to characterise the relationship between adolescent weight status using standardised relative body mass ascertained from high school photograph portraits in 1957 and depressive symptoms at age 65 using the Center for Epidemiologic Studies Depression Scale measured in 2004. RESULTS women who were overweight in adolescence were significantly more likely to experience depressive symptoms in later adulthood than their normal weight counterparts (odds ratio [OR] = 1.740) when the full set of controls was included. This relationship was not observed among men. The relationship between womens adolescent weight status and later life depressive symptoms was moderated by childhood socioeconomic status, and adolescent overweight was more predictive of later life depressive symptoms for women who were raised in low- and middle-income families (OR = 2.568 and OR = 2.763) than in high-income families (OR = 1.643). CONCLUSION these findings provide further evidence for the wide range of long-term consequences of adolescent overweight on later life well-being and are notable for the gender differences in the connection between early life circumstances and later life mental health.